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NOTICE OF RESTRICTION OF USE <br />ATE: - 7)a- , �)' 1 ]11 <br />D <br />LOCATION (PARK/OPEN SPACEK <br />- TIME: CASE #-. <br />I <br />Underthe authority ofAdministrative OrderNo. 58-03-24-F and Park and Open Space Rule R-1.0050),you are hereby <br />notified that you are prohibited from (check box): <br />404' Entering in or using all City of Eugene parks, open spaces or facilities. <br />W <br />The basis for this Notice of Restriction of Use is that on you violated Section 1 01 '( f the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS . ........... To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until <br />If you enter in or use any City of Eugene park, open space or facility during the effective period Of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R- you are entitled to an infortnal hearing to contest this Notice. A request for an <br />in ronrial hearing rarest be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />0402, <br />The Di Director shall schedule a time and place for the infOrmal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testier ony , from the in Formal hearing, <br />This Notice shall remain in effect pending any requested bearing. <br />This Notice of'Exclusion was delivered to the person narned at the top of this No date and time shown above by <br />- f + <br />---------- 11 ------ <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy, Public Work's Gwen Copy: F& yellow cnpy; Report Copy Nnk Copy: Rtcipient Gold Copy: Officer Appeal ono ice R-r", tW03 <br />Nanie: Last First Middle <br />DOB: <br />7 <br />Res, Address: City <br />Statc <br />asp <br />Re"". phmle <br />`ork Phvne� <br />Underthe authority ofAdministrative OrderNo. 58-03-24-F and Park and Open Space Rule R-1.0050),you are hereby <br />notified that you are prohibited from (check box): <br />404' Entering in or using all City of Eugene parks, open spaces or facilities. <br />W <br />The basis for this Notice of Restriction of Use is that on you violated Section 1 01 '( f the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS . ........... To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until <br />If you enter in or use any City of Eugene park, open space or facility during the effective period Of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R- you are entitled to an infortnal hearing to contest this Notice. A request for an <br />in ronrial hearing rarest be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />0402, <br />The Di Director shall schedule a time and place for the infOrmal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testier ony , from the in Formal hearing, <br />This Notice shall remain in effect pending any requested bearing. <br />This Notice of'Exclusion was delivered to the person narned at the top of this No date and time shown above by <br />- f + <br />---------- 11 ------ <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy, Public Work's Gwen Copy: F& yellow cnpy; Report Copy Nnk Copy: Rtcipient Gold Copy: Officer Appeal ono ice R-r", tW03 <br />